Preterm Infant Growth Velocity

Calculations: A Systematic Review

Tanis R. Fenton, PhD, RD, FDC,a,b Hilton T. Chan,c Aiswarya Madhu,c Ian J. Griffin, MD,d Angela
Hoyos, MD,e Ekhard E. Ziegler, MD,f Sharon Groh-Wargo, PhD, RD,g Susan J. Carlson, MMSc, RD,f
Thibault Senterre, MD, PhD,h Diane Anderson, PhD, RD,i Richard A. Ehrenkranz, MDj

CONTEXT: Clinicians assess the growth of preterm infants and compare growth velocity using a abstract
variety of methods.
OBJECTIVE: We determined the numerical methods used to describe weight, length, and head
circumference growth velocity in preterm infants; these methods include grams/kilogram/
day (g/kg/d), grams/day (g/d), centimeters/week (cm/week), and change in z scores.
DATA SOURCES: A search was conducted in April 2015 of the Medline database by using PubMed
for studies that measured growth as a main outcome in preterm neonates between birth
and hospital discharge and/or 40 weeks’ postmenstrual age. English, French, German, and
Spanish articles were included. The systematic review was conducted by using Preferred
Reporting Items for Systematic Reviews and Meta-analyses methods.
STUDY SELECTION: Of 1543 located studies, 373 (24%) calculated growth velocity.

DATA EXTRACTION: We conducted detailed extraction of the 151 studies that reported g/kg/d
weight gain velocity.
RESULTS: A variety of methods were used. The most frequently used method to calculate
weight gain velocity reported in the 1543 studies was g/kg/d (40%), followed by g/d
(32%); 29% reported change in z score relative to an intrauterine or growth chart. In the
g/kg/d studies, 39% began g/kg/d calculations at birth/admission, 20% at the start of the
study, 10% at full feedings, and 7% after birth weight regained. The kilogram denominator
was not reported for 62%. Of the studies that did report the denominators, the majority
used an average of the start and end weights as the denominator (36%) followed by
exponential methods (23%); less frequently used denominators included birth weight
(10%) and an early weight that was not birth weight (16%). Nineteen percent (67 of 355
studies) made conclusions regarding extrauterine growth restriction or postnatal growth
failure. Temporal trends in head circumference growth and length gain changed from
predominantly cm/wk to predominantly z scores.
LIMITATIONS AND CONCLUSIONS The lack of standardization of methods used to calculate preterm
infant growth velocity makes comparisons between studies difficult and presents an
obstacle to using research results to guide clinical practice.

aDepartment of Community Health Sciences, Institute of Public Health, Alberta Children’s Hospital Research Institute, and cCumming School of Medicine, University of Calgary, Calgary,

Alberta, Canada; bNutrition Services, Alberta Health Services, Calgary, Alberta, Canada; dUC Davis Medical Center, Sacramento, California; eClínica del Country, Universidad el Bosque,
Bogotá, Colombia; fUniversity of Iowa Children’s Hospital, Iowa City, Iowa; gCase Western Reserve University School of Medicine, Cleveland, Ohio; hCHU de Liege, CHR de la Citadelle, University
of Liege, Liege, Belgium; iBaylor College of Medicine, Houston, Texas; and jYale School of Medicine, New Haven, Connecticut

To cite: Fenton TR, Chan HT, Madhu A, et al. Preterm Infant Growth Velocity Calculations: A Systematic Review. Pediatrics. 2017;139(3):e20162045

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PEDIATRICS Volume 139, number 3, March 2017:e20162045 REVIEW ARTICLE
During the third trimester of
gestation, the human fetus, whose
growth rates preterm infants are
recommended to mimic,1,2 grows
from ∼500 to 3500 g between 22
and 40 weeks of gestation, a 7 times
multiple in only 4 months.3 Such
growth velocity is faster than other
age groups. Although preterm infants
can double or triple their weight
during their first 2 to 3 months,4–7
term infants take 4 to 5 months and
teenagers take 9 years to double their
weight.8 Preterm infants without
morbidities can replicate these rapid
fetal growth rates when nutrition is
not limiting.9,10

Length gain is also rapid during

gestation. Term infants have an
average length of ∼50 cm after
9 months of gestation, whereas
length growth in the first year of life
(25 cm in 12 months) is one-half of FIGURE 1
that amount grown in a longer time Flow diagram of articles identified in the literature search, screened, found eligible, and included in
the systematic review.
period.8

Measuring growth velocity in
preterm infants is of crucial
importance because poor growth
is associated with severe long-term
outcomes.11–13 Growth patterns of
preterm infants have changed with
recent advances in medical14–16 and
nutritional14,17–19 care. Researchers
in several countries have observed
that rates of growth failure have
declined in the past decade.14,18,19
Our previous research revealed that
compared with infants born between
1994 and 1995, infants born between
2001 and 2009 regained their
birth weight sooner after birth and
experienced higher rates of weight
gain.17
Several investigators have identified
that researchers use a variety of
methods to summarize growth
velocity of preterm infants.20–22
Assessing grams/kilogram/day (g/
kg/d) calculation methods for birth
until discharge, Patel et al21,23 and
Senterre and Rigo,20 in separate
analyses, found that different
calculation methods have been
documented to alter results by as
much as 73% in g/kg/d estimates.
We believe that research is needed
to identify which methods to
quantify preterm infant growth are
superior and which are inferior.
We also see a need to make
recommendations to achieve some
uniformity of methods used so the
neonatal community can achieve
the best conclusions about growth
and to support comparisons across
research studies. This initial article
by our group defines the range of
growth velocity methods used by the
neonatal community; it describes
the problem of using many different
methods, making comparisons
TABLE 1 Frequency of Methods Used to Report Weight Gain in the Studies of Preterm Infant Weight
Gain Before Term Age, Before and After 2005, in the 1543 Located Studies
Variable
Overall
<2005*
2005–2015*
* P < .001.
between studies and centers difficult,
if not impossible. The additional
research is large enough to justify
additional articles; we view this
article as the first of a series.
We hypothesized that a systematic
review to describe the range of
numerical summary methods used
in the literature to calculate growth
velocity of early preterm infants,
and to quantify the frequency of
each method, would identify a
large variety of methods. The
purpose of the present study was
to determine the frequency
of numerical methods used to
quantify growth velocity (weight
gain as g/kg/d, grams/day [g/d],
g/d g/kg/d Z Score
120 (32%) 151 (40%) 108 (29%)
71 (59%) 67 (44%) 21 (19%)
49 (41%) 84 (56%) 87 (81%)

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2 FENTON et al
and change in z score [SD score];
head circumference and length
as centimeters/week [cm/wk]
and z scores) in preterm infants
(gestational age <37 weeks at
birth) who had growth assessed at
or before hospital discharge and/
or 40 weeks’ postmenstrual age
in published studies that reported
growth as a primary outcome. The
primary objective was to examine
the variability of the g/kg/d
calculations, the time frames, and
the denominators. The secondary
objective was to document the
variability of methods for the
calculation of gain in weight, head
circumference, and length.

METHODS
A search was conducted of the
Medline database in April 2015 for
published studies that reported
growth as a main outcome in
preterm infants between birth and
hospital discharge or 40 weeks’
postmenstrual age. The systematic
review methods recommended
by the Preferred Reporting Items
for Systematic Reviews and Meta-
analyses statement24 were used.
Search terms included the Medical
Subject Headings and text words:
(“Infant, Premature”[Mesh]
OR “Infant, Very Low Birth
Weight”[Mesh]) and (“Weight
Gain”[Mesh] OR “growth velocity”
OR (weight and “rate of growth”)
OR ((“g/kg/day” OR “g/kg/d”) and
weight) OR ((z-score OR z-scores
OR “SD score” OR “SD scores”) and
change and weight)).
This search was conducted in
Medline (PubMed), and it was
not limited by date of publication.
Intervention and observational
studies were included in English,
French, Spanish, and German
languages. Because our objective FIGURE 2
Temporal trends of the frequency of reported weight gain calculations for preterm infants before
was to quantify the methods used term age: (A) g/kg/d, (B) g/d, and (C) z scores.
in the published literature, authors
were not contacted for additional
information, and studies were

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PEDIATRICS Volume 139, number 3, March 2017 3
not assessed for risk of bias. We TABLE 2 Growth Charts Used to Assign Z Scores for Weight Gain ≥2 Times to Either Assign Z Scores
noted when the method used or Postnatal Growth Failure Identified in the 2015 Literature Search
was not reported. Gray literature Intrauterine or Preterm Growth Chart Frequency for Z Scores Frequency for Postnatal Growth
was not included because a pilot Failure
search located sufficient studies Alexander et al 199633 4 (6%) 4 (10%)
to indicate that the search of the 1 Babson 197032 5 (7%) 1 (3%)
database would be able to provide a Cole et al 199831 5 (7%) 1 (3%)
Fenton 200328 18 (25%) 11 (27%)
description of the range of methods
Fenton et al 201317 6 (8%) 4 (10%)
used to report growth of preterm Kramer et al 200134 2 (3%) 2 (5%)
infants. Kitchen et al 198335 1 (1%) 2 (5%)
Lubchenco et al 196636 3 (4%) 2 (5%)
After reading selected abstracts, Niklasson et al 199137 4 (5%) 1 (3%)
further examination of full articles Olsen et al 201030 5 (7%) 2 (5%)
Pihkala et al 198938 2 (3%) 2 (5%)
and the inclusion of relevant articles Roberts and Lancaster 199939 2 (3%) 1 (3%)
were made based on previously Skjaerven et al 200040 3 (4%) 2 (5%)
determined inclusion and exclusion Usher and McClean 196929 9 (12%) 4 (10%)
criteria. The inclusion criteria for Voigt et al 201041 2 (3%) 0
the articles were: (1) growth as a Yudkin et al 198742 2 (3%) 2 (5%)
main outcome, measured in terms Charts that were used by only 1 study for either to assign z scores or growth failure were not included in this table.

of weight gain, or growth of head

circumference and/or length; and
(2) participants of the study were
preterm infants (gestational age <37
weeks). The exclusion criteria for
the selected articles were as follows:
(1) the only growth end point was
>40 weeks’ postmenstrual age; (2)
not all participants of the study were
preterm; (3) lack of reported data
in the article; and (4) animal studies
and review articles. Because the
interest in this systematic review was
about how growth was calculated,
studies when researchers reported
size (eg, mean weight or head
circumference at discharge) without
growth summarized over time were
not included.

Two reviewers extracted the

data from the English articles;
any differences of opinion were
resolved in discussion with one
of the collaborators. One of the
collaborators each extracted the
data from the French, Spanish, and
German articles, with discussions
with the principal investigator
about any dilemmas. The data were
extracted in a 2-part process. The
following information was extracted
from all 373 included articles: (1)
authors, year of publication, and first
title word; (2) PubMed identification
number; (3) whether weight gain,
FIGURE 3
Temporal trends of the frequency of reported postnatal growth failure or extrauterine growth
restriction.
growth of head circumference, and/
or length was included; (4) how
weight gain was summarized (g/
day, g/kg/d, z scores, or other);
(5) whether weight was assessed
for extrauterine growth restriction
or postnatal growth failure using
size less than the 10th percentile
or similar; and (6) if z scores or a
percentile was used to assess growth
at discharge to assess growth failure,
and which growth or intrauterine
chart was used as the comparison
reference.
In the second extraction step, the 151
articles (Supplemental References)
that reported growth velocity in g/
kg/d were examined in more detail for:
(1) which denominator and whether
an exponential transformational term
was used for the g/kg/d calculation;

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4 FENTON et al
TABLE 3 Time Reported for the Beginning and End of Calculations in the 151 Studies of Preterm Infant
g/kg/d Weight Gain Before Term Age
Start Times
Birth/day 1/admission
Study start/randomization
Full feeds
Day of life 3 to 13
Regain birth weight
Feeding initiation
Weight nadir
Other
Not specified
(2) the time frame for which growth
was measured; and (3) how growth
in head circumference and/or length
was summarized (cm/wk, change in z
scores, or other).
The methods reported in the
included studies were described by
using frequencies and percentages:
g/d, g/kg/d, cm/wk, change in z
scores, percentile, or other. For g/
kg/d, the denominator used and
whether an exponential method was
used were documented. Frequencies
of the methods used over time were
illustrated graphically. The statistical
comparison of the frequencies of
velocity calculations before and after
2005 was made by using Fisher’s
exact test.
RESULTS
Description of Studies
Among the 1543 studies located in the
search, 373 (24%) reported growth
velocity of the infants studied and
were included in the systematic review
(Fig 1). Studies were excluded at the
abstract stage if growth was not a
primary outcome (n = 670 [43%]), the
article was a review article (n = 157
n % End Times n %
59 39 Discharge 45
30 20 Day of life 7 to 56 50
15 10 Study end 21
14 9 34–40 wk gestational age 15
11 7 Weight 1.7–2 kg 10
2 1 Other 3 2
2 1 Not specified 8 5
11 7 2005 was g/d; the change in z scores
8 5
[10%]), growth was only calculated
with an end point after term age (n =
108 [7%]), language was other than
1 of the 4 included languages (n = 69
[4%]), they were animal studies (n =
13 [1%]), preterm and term infants
were grouped together (n = 10, 1%),
and it was a duplicate publication (n =
2 [0.1%]). Studies were excluded at the
article stage if no growth data (n = 81
[5%]) or if size (and not growth) was
reported (n = 58 [4%]).
Weight Gain, or Growth of Head
Circumference, and/or Length
Inclusion
Among the 373 included studies,
weight gain was assessed in 95% (n
= 355), head circumference growth
in 51% (n = 191), and length gain in
48% (n = 180).
Methods Used to Calculate Weight
Gain Velocity
The most frequently used method to
calculate weight gain velocity reported
in the 1543 studies was g/kg/d (40%),
followed by g/d (32%); 29% reported
change in z score relative to an
intrauterine or growth chart (Table 1).
Some studies used >1 method; thus, the
sum of these methods totals >100%.
Of the studies that reported weight
gain, 17% (n = 59) reported using 2
30 methods, and 2.2% (n = 8) reported all
33 3 methods (g/kg/d, g/d, and change in
14 z score). The methods used to calculate
10 weight gain velocity varied significantly
7
over time (Table 1, Fig 2). The most
frequently reported method before
was the most frequently used method
between 2005 and 2015.
The first reports using each weight
gain calculation method were
published in 1947 for g/kg/d,25 1966
for g/d,26 and 1979 for z scores.27
Calculation of Z Scores
The calculation of z scores requires
a growth reference from which
to calculate how many SDs a
measurement is from the median/
mean of either an intrauterine or
preterm growth chart. Of the 108
studies that reported using z scores to
calculate growth of preterm infants,
most (n = 104 [96%]) reported which
chart they used for comparison. The
most frequently reported reference
charts for the calculation of z scores in
this 2015 literature search were those
published by Fenton28 in 2003 (25%),
Usher and McLean29 in 1969 (12%),
Fenton and Kim3 in 2013 (8%), Olsen
et al30 in 2010 (7%), Cole et al31 in
1998 (7%), and Babson32 in 1976
(7%) (Table 2).
Assessment of Extrauterine Growth
Restriction or Postnatal Growth
Failure
Almost one-fifth of the studies (19%
[67 of the 355 weight studies])
evaluated the weight gain of preterm

TABLE 4 Frequencies of Methods Used to Report Head Circumference and Length Growth in the 151 Studies That Reported Weight Gain as g/kg/d for
Preterm Infants
Variable Head Circumference (n = 74 [49%]) Length (n = 74 [49%])
cm/wk Change in Z Scores cm/wk Change in Z Scores
Overall 46 (61%) 20 (27%) 44 (59%) 18 (24%)
<2005* 28 (61%) 1 (5%) 27 (61%) 1 (6%)
2005–2015* 18 (39%) 19 (95%) 17 (39%) 17 (94%)
* P < .001 for changes over time for both head circumference and length.

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PEDIATRICS Volume 139, number 3, March 2017 5

FIGURE 4
Temporal trends of the frequency of reported head circumference (HC) calculations for preterm
infants before term age, among the 151 papers that reported g/kg/d weight gain calculations: (A)
cm/week, (B) z-scores.
infants at discharge or at a point after
the early postnatal weight loss and
made conclusions about extrauterine
growth restriction or postnatal growth
failure. This evaluation of postnatal
growth has become more frequent
in recent years (11% of the pre-2005
studies [16 of 152] and 25% [51 of
203] of the 2005–2015 studies, among
the 355 studies that evaluated weight)
(Fig 3). The most frequently reported
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6 FENTON et al
reference charts for the calculation of
postnatal growth failure in this 2015
literature search were those published
by Fenton28 in 2003, Alexander et al33
in 1996, Fenton and Kim3 in 2013,
and Usher and MacLean29 in 1969
(Table 2).
Calculation Methods Using g/kg/d
The time frames and denominators
used for the 151 studies that
reported g/kg/d varied among
the studies, and some calculated
the growth velocity over subdivisions
of time within the studies
(Table 3).
The most frequently reported
time of the start of the g/kg/d
calculations was on the day of birth,
day 1, or NICU admission (39%),
followed by the start of a study
(20%) or at the achievement of full
feeds (10%) (Table 3).
Less frequent g/kg/d calculation
starting times were when birth
weight was regained (7%), the
weight nadir (1%), and at the time
of feeding initiation (1%). The
most frequent end time of the g/
kg/d calculations was at the time
of discharge (30%). Many of the
studies used a specific day-of-life
to end their g/kg/d calculations,
and these ranged from day 7 to day
56, with a mode of 28 days
(n = 21 [42%]). Several studies (7%)
used a specific weight for the end
of the g/kg/d calculation; the most
frequently used weight was equal
to 2 kg.
The majority of studies that
reported g/kg/d calculations did
not report what they used for the
weight as denominator (n = 94
[62%]). Of the studies that reported
the denominators for the g/kg/d
calculations, the majority used an
average of the start and end weights
as the denominator (36%) followed
by exponential methods (23%).
Less frequently used denominators
included birth weight (10%) and
an early weight that was not birth
weight (16%). Seven of the studies
(11%) reported performing a daily g/
kg/d calculation; 4 of these reported
that they used the weight on the
previous day for the denominator, 2
studies used the average weight, and
the remaining study reported using
the later weight.
Several studies reported using
subdivisions of time to calculate
the g/kg/d velocity. The most
commonly used subdivision was
calculation of g/kg/d weekly (n =
15), whereas 3 studies calculated it
daily. Six studies reported g/kg/d
growth velocity over 2 time periods,
such as birth to regain birth weight,
followed by regained birth weight
to the end of the study. Nine studies
calculated the g/kg/d velocity over
a unique set of time subdivisions,
including days 1 to 7, days 1 to 35,
days 8 to 35, and days 1 to 70.43

Head Circumference and Length

Growth Velocity Calculations
Almost one-half of the 152 studies
that reported g/kg/d growth
velocity calculations reported that
they calculated head circumference
and length (n = 74 [49% for both])
growth (Table 4). The most common
methods used for calculating head
and length growth velocity were as
cm/wk. We included calculations
that were simple mathematic
variations (eg, millimeters/day
and centimeters/4 weeks) in the
counts for cm/week, followed by
z scores. The first reports of head
circumference and length growth
velocity calculations were reported
as growth in cm/wk in 1979.44
The first reports of z scores for
both head and length growth
was in a study by Simmer et al,45
published in 1997, in which they
used the 1983 intrauterine growth
chart by Kitchen et al35 as the growth
reference. FIGURE 5
Temporal trends of the frequency of reported length calculations for preterm infants before term
Similar to weight gain, there age, among the 151 papers that reported g/kg/d weight gain calculations: (A) cm/week, (B) z-scores.
were temporal trends in the use of
head circumference and length velocity
velocity methods (a wide variety different methods used make
calculations over time.
of measurements and time comparisons between studies and
The most frequently reported methods
frames) that have been used centers difficult, if not impossible.
before 2005 used cm/wk, whereas
by the neonatal community to Additional research is needed to
the change in z scores was the most
report growth of preterm infants. provide guidance for clinicians and
frequently used method between 2005
Every aspect of growth velocity researchers; we see this article as
and 2015 (Table 4, Figs 4 and 5).
calculations varied considerably. the first in a series of articles.
Weight gain was calculated more
frequently than head circumference One-quarter of the recent studies
DISCUSSION
and length gain, with the latter of preterm infant weight gain made
This first article by our group measures more prevalent in the conclusions about extrauterine
describes the range of growth more recent studies. The many growth restriction or growth

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PEDIATRICS Volume 139, number 3, March 2017 7
failure. A large proportion of
healthy preterm infants have
weights below the 10th percentile
on growth charts after the
postnatal extracellular water loss
early in postnatal life.46 Thus, the
frequent consideration of weights
less than the 10th percentile as
extrauterine growth restriction and
postnatal growth failure may not be
appropriate. We endorse the Pre-B
Working Groups’ recommendation
that assigning extrauterine growth
restriction or postnatal growth
failure at the time of discharge is
not appropriate.47 They recommend
that it is appropriate to use the
growth rate of the fetus beginning
after the physiologic extracellular
volume loss as the growth goal
for preterm infants. It is likely
more appropriate to evaluate
the discharge weight, length
and head circumference, and z
score/percentiles relative to the
postphysiologic weight nadir at 2
to 3 weeks of age rather than birth
size.48 Other investigators proposed
using day 3 as the start point,
considering that it is the postnatal
age when weight nadir ideally
occurs (when early postnatal
nutrition is optimized).19
We believe that research is needed
to identify which methods are
superior and which are inferior in
terms of quantifying preterm infant
growth. Research is also needed
to identify which preterm infants
actually have growth failure and
how these infants can be identified
by using tools readily available to
clinicians.
The most prevalent growth velocity
measurements have been g/kg/d
for weight gain and cm/wk for head
circumference and length. There
have been some temporal changes
in the growth velocity calculations
used for preterm infants, with g/d
and cm/wk being more prevalent
in the earlier studies, and z scores
becoming popular more recently
for weight, head circumference,
and length (Figs 2–4). The most
frequently used period for preterm
infant weight gain velocity
calculations was from birth to
discharge, which was used by 30%
of the reviewed studies.
A substantial proportion of the
studies used an exponential
calculation of weight gain velocity
(23%). Whether an exponential
model is relevant is questionable
because the rapid early growth
rates of infants does not persist or
continue in an exponential fashion
but rather decreases rapidly after
early infancy.49
The present study was limited by
its observational nature and the
frequently incomplete reporting of
the methods used in the reviewed
studies. An additional limitation
was that we only quantified
head circumference and length
measurements in the 152 studies that
reported g/kg/d calculations; thus,
we did not capture all of these data in
the other 221 studies that calculated
growth velocity of preterm infants.
The lack of consistency of methods
used to quantify preterm infant
growth illustrates that there is a
need to develop clinical practice
recommendations to standardize
preterm infant growth calculations
to allow for comparisons between
studies.
CONCLUSIONS
The lack of standardization
of methods used to calculate
preterm infant growth velocity
makes comparisons between
studies difficult and presents an
obstacle for the use of research
results to guide clinical practice.
It is important for researchers to
identify which growth charts were
used to calculate z scores. At the
very least, reports need to describe
the methods used for calculation of
growth velocity.

Dr Fenton led the design of the study, independently extracted and verified raw data from publications, conducted the initial analysis, and drafted the initial
manuscript; and Dr Fenton, Mr Chan, Ms Madhu, Ms Carlson, and Drs Griffin, Groh-Wargo, Hoyos, Senterre, and Ziegler independently extracted and verified raw
data from publications. All authors helped design the study, assisted in the preparation of the manuscript, approved the final manuscript as submitted, and
agree to be accountable for all aspects of the work.
DOI: 10.1542/peds.2016-2045
Accepted for publication Dec 12, 2016
Address correspondence to Tanis R. Fenton, PhD, RD, FDC, Nutrition Services, Alberta Health Services, 1403 29 Str NW, Calgary, AB, Canada T2N 2T9. E-mail:
tfenton@ucalgary.ca
PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).
Copyright © 2017 by the American Academy of Pediatrics
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
FUNDING: No external funding.
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

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8 FENTON et al
REFERENCES
1. Agostoni C, Buonocore G, Carnielli
VP, et al; ESPGHAN Committee on
Nutrition. Enteral nutrient supply for
preterm infants: commentary from
the European Society of Paediatric
Gastroenterology, Hepatology and
Nutrition Committee on Nutrition.
J Pediatr Gastroenterol Nutr.
2010;50(1):85–91
2. Committee on Nutrition American
Academy Pediatrics. Nutritional needs
of preterm infants. In: Pediatric
Nutrition Handbook. 7th ed. Elk Grove
Village, IL: American Academy of
Pediatrics; 2014
3. Fenton TR, Kim JH. A systematic review
and meta-analysis to revise the Fenton
growth chart for preterm infants. BMC
Pediatr. 2013;13:59
4. Giannì ML, Roggero P, Colnaghi
MR, et al. The role of nutrition in
promoting growth in pre-term infants
with bronchopulmonary dysplasia:
a prospective non-randomised
interventional cohort study. BMC
Pediatr. 2014;14:235
5. Rochow N, Fusch G, Mühlinghaus A,
et al. A nutritional program to improve
outcome of very low birth weight
infants. Clin Nutr. 2012;31(1):124–131
6. Hair AB, Hawthorne KM, Chetta KE,
Abrams SA. Human milk feeding
supports adequate growth in infants
≤ 1250 grams birth weight. BMC Res
Notes. 2013;6:459
7. Isemann B, Mueller EW, Narendran
V, Akinbi H. Impact of early sodium
supplementation on hyponatremia
and growth in premature infants:
a randomized controlled trial.
JPEN J Parenter Enteral Nutr.
2016;40(3):342–349
8. World Health Organization. The WHO
Child Growth Standards. Available at:
www.who.int/childgrowth/en/
9. Olsen IE, Richardson DK, Schmid
CH, Ausman LM, Dwyer JT. Intersite
differences in weight growth velocity
of extremely premature infants.
Pediatrics. 2002;110(6):1125–1132
10. Embleton ND, Cooke RJ. Protein
requirements in preterm infants: effect
of different levels of protein intake on
Downloaded from www.aappublications.org/news by guest on September 11, 2019
PEDIATRICS Volume 139, number 3, March 2017
growth and body composition. Pediatr
Res. 2005;58(5):855–860
11. Ehrenkranz RA, Dusick AM, Vohr
BR, Wright LL, Wrage LA, Poole WK.
Growth in the neonatal intensive care
unit influences neurodevelopmental
and growth outcomes of extremely
low birth weight infants. Pediatrics.
2006;117(4):1253–1261
12. Belfort MB, Rifas-Shiman SL, Sullivan
T, et al. Infant growth before and after
term: effects on neurodevelopment
in preterm infants. Pediatrics.
2011;128(4). Available at: www.
pediatrics.org/cgi/content/full/128/4/
e899
13. Franz AR, Pohlandt F, Bode H, et
al. Intrauterine, early neonatal,
and postdischarge growth and
neurodevelopmental outcome at 5.4
years in extremely preterm infants
after intensive neonatal nutritional
support. Pediatrics. 2009;123(1).
Available at: www.pediatrics.org/cgi/
content/full/123/1/e101
14. Flesher SL, Domanico RS. Improved
growth and development in premature
infants managed with nasal
continuous positive airway pressure.
W V Med J. 2014;110(2):14, 16–18
15. Horbar JD, Carpenter JH, Badger
GJ, et al. Mortality and neonatal
morbidity among infants 501 to 1500
grams from 2000 to 2009. Pediatrics.
2012;129(6):1019–1026
16. Shah PS, Sankaran K, Aziz K, et al;
Canadian Neonatal Network. Outcomes
of preterm infants <29 weeks
gestation over 10-year period in
Canada: a cause for concern?
J Perinatol. 2012;32(2):132–138
17. Fenton TR, Nasser R, Eliasziw M,
Kim JH, Bilan D, Sauve R. Validating
the weight gain of preterm infants
between the reference growth curve
of the fetus and the term infant. BMC
Pediatr. 2013;13:92
18. Ofek Shlomai N, Reichman B, Lerner-
Geva L, Boyko V, Bar-Oz B. Population-
based study shows improved
postnatal growth in preterm very-low-
birthweight infants between 1995 and
2010. Acta Paediatr. 2014;103(5):
498–503
19. Senterre T, Rigo J. Optimizing early
nutritional support based on recent
recommendations in VLBW infants and
postnatal growth restriction. J Pediatr
Gastroenterol Nutr. 2011;53(5):536–542
20. Senterre T, Rigo J. Reduction in
postnatal cumulative nutritional
deficit and improvement of growth
in extremely preterm infants. Acta
Paediatr. 2012;101(2):e64–e70
21. Patel AL, Engstrom JL, Meier PP,
Kimura RE. Accuracy of methods for
calculating postnatal growth velocity
for extremely low birth weight infants.
Pediatrics. 2005;116(6):1466–1473
22. Martin CR, Brown YF, Ehrenkranz
RA, et al; Extremely Low Gestational
Age Newborns Study Investigators.
Nutritional practices and growth
velocity in the first month of life
in extremely premature infants.
Pediatrics. 2009;124(2):649–657
23. Patel AL, Engstrom JL, Meier PP, Jegier
BJ, Kimura RE. Calculating postnatal
growth velocity in very low birth
weight (VLBW) premature infants.
J Perinatol. 2009;29(9):618–622
24. Liberati A, Altman DG, Tetzlaff J,
et al. The PRISMA statement for
reporting systematic reviews and
meta-analyses of studies that evaluate
health care interventions: explanation
and elaboration. J Clin Epidemiol.
2009;62(10):e1–e34
25. Gordon HH, Levine SZ, McNamara
H. Feeding of premature infants; a
comparison of human and cow’s milk.
Am J Dis Child. 1947;73(4):442–452
26. Nichols MM, Danford BH. Feeding
premature infants: a comparison of
effects on weight gain, blood and urine
of two formulas with varying protein
and ash composition. South Med J.
1966;59(12):1420–1424
27. Marks KH, Maisels MJ, Moore E, Gifford
K, Friedman Z. Head growth in sick
premature infants—a longitudinal
study. J Pediatr. 1979;94(2):282–285
28. Fenton TR. A new growth chart for
preterm babies: Babson and Benda’s
chart updated with recent data and a
new format. BMC Pediatr. 2003;3:13
9
 29. Usher R, McLean F. Intrauterine growth
of live-born Caucasian infants at
sea level: standards obtained from
measurements in 7 dimensions
of infants born between 25 and
44 weeks of gestation. J Pediatr.
1969;74(6):901–910
30. Olsen IE, Groveman SA, Lawson ML,
Clark RH, Zemel BS. New intrauterine
growth curves based on United States
data. Pediatrics. 2010;125(2). Available
at: www.pediatrics.org/cgi/content/
full/125/2/e214
31. Cole TJ, Freeman JV, Preece MA.
British 1990 growth reference centiles
for weight, height, body mass index
and head circumference fitted by
maximum penalized likelihood. Stat
Med. 1998;17(4):407–429
32. Babson SG. Growth of low-birth-weight
infants. J Pediatr. 1970;77(1):11–18
33. Alexander GR, Himes JH, Kaufman
RB, Mor J, Kogan M. A United States
national reference for fetal growth.
Obstet Gynecol. 1996;87(2):163–168
34. Kramer WS, Platt RW, Wen SW, et al.
Fetal/Infant Health Study Group of
the Canadian Perinatal Surveillance
System. A new and improved
population-based Canadian reference
for birth weight for gestational age.
Pediatrics. 2001;108(2):E35
35. Kitchen WH, Robinson HP, Dickinson AJ.
Revised intrauterine growth curves for
an Australian hospital population. Aust
Paediatr J. 1983;19(3):157–161
36. Lubchenco LO, Hansman C, Boyd E.
Intrauterine growth in length and
head circumference as estimated
Downloaded from www.aappublications.org/news by guest on September 11, 2019
10
from live births at gestational ages
from 26 to 42 weeks. Pediatrics.
1966;37(3):403–408
37. Niklasson A, Ericson A, Fryer JG,
Karlberg J, Lawrence C, Karlberg P.
An update of the Swedish reference
standards for weight, length and
head circumference at birth for given
gestational age (1977-1981). Acta
Paediatr Scand. 1991;80(8-9):
756–762
38. Pihkala J, Hakala T, Voutilainen P,
Raivio K. Characteristic of recent fetal
growth curves in Finland [in Finnish].
Duodecim. 1989;105:1540–1546
39. Roberts CL, Lancaster PA. Australian
national birthweight percentiles
by gestational age. Med J Aust.
1999;170(3):114–118
40. Skaerven R, Gjessing HK, Bakketeig
LS. Birthweight by gestational age in
Norway. Acta Obstet Gynecol Scand.
2000;79(6):440–449
41. Voigt M, Rochow N, Straube S, Briese
V, Olbertz D, Jorch G. Birth weight
percentile charts based on daily
measurements for very preterm
male and female infants at the age
of 154–223 days. J Perinat Med.
2010;38(3):289–295
42. Yudkin PL, Aboualfa M, Eyre JA,
Redman CW, Wilkinson AR. New
birthweight and head circumference
centiles for gestational ages
24 to 42 weeks. Early Hum Dev.
1987;15(1):45–52
43. Loui A, Bührer C. Growth of very low
birth weight infants after increased
amino acid and protein administration.
J Perinat Med. 2013;41(6):735–741
44. Brooke OG, Alvear J, Arnold M. Energy
retention, energy expenditure, and
growth in healthy immature infants.
Pediatr Res. 1979;13(4 pt 1):
215–220
45. Simmer K, Metcalf R, Daniels L. The use
of breastmilk in a neonatal unit and
its relationship to protein and energy
intake and growth. J Paediatr Child
Health. 1997;33(1):55–60
46. Rochow N, Raja P, Liu K, et al.
Physiological adjustment to
postnatal growth trajectories in
healthy preterm infants. Pediatr Res.
2016;79(6):870–879
47. Raiten DJ, Steiber AL, Carlson SE, et al;
Pre-B Consultative Working Groups.
Working group reports: evaluation
of the evidence to support practice
guidelines for nutritional care of
preterm infants—the Pre-B Project.
Am J Clin Nutr. 2016;103(2):
648S–678S
48. Cole TJ, Statnikov Y, Santhakumaran
S, Pan H, Modi N; Neonatal Data
Analysis Unit and the Preterm Growth
Investigator Group. Birth weight and
longitudinal growth in infants born
below 32 weeks’ gestation: a UK
population study. Arch Dis Child
Fetal Neonatal Ed. 2014;99(1):
F34–F40
49. de Onis M, Siyam A, Borghi E, Onyango
AW, Piwoz E, Garza C. Comparison of
the World Health Organization growth
velocity standards with existing US
reference data. Pediatrics. 2011;128(1).
Available at: www.pediatrics.org/cgi/
content/full/128/1/e18
FENTON et al
 Preterm Infant Growth Velocity Calculations: A Systematic Review
Tanis R. Fenton, Hilton T. Chan, Aiswarya Madhu, Ian J. Griffin, Angela Hoyos,
Ekhard E. Ziegler, Sharon Groh-Wargo, Susan J. Carlson, Thibault Senterre, Diane
Anderson and Richard A. Ehrenkranz
Pediatrics 2017;139;
DOI: 10.1542/peds.2016-2045 originally published online February 28, 2017;

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 Preterm Infant Growth Velocity Calculations: A Systematic Review
Tanis R. Fenton, Hilton T. Chan, Aiswarya Madhu, Ian J. Griffin, Angela Hoyos,
Ekhard E. Ziegler, Sharon Groh-Wargo, Susan J. Carlson, Thibault Senterre, Diane
Anderson and Richard A. Ehrenkranz
Pediatrics 2017;139;
DOI: 10.1542/peds.2016-2045 originally published online February 28, 2017;

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located on the World Wide Web at:
http://pediatrics.aappublications.org/content/139/3/e20162045

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http://pediatrics.aappublications.org/content/suppl/2017/02/24/peds.2016-2045.DCSupplemental

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